For Melbourne bioethicist Nicholas Tonti-Filippini euthanasia is more than academic. He is in chronic pain with a terminal illness. Earlier this week he published an open letter to the Premier of South Australia, Mike Rann, urging him not to support Voluntary Euthanasia Bill 2010. (It was defeated yesterday.) Dr Tonti-Filippini's professional credentials are impressive. He was Australia's first hospital bioethicist and is a member of the Australian Health Ethics Committee of the National Health and Medical Research Council and chair of the sub-committees on the Unresponsive State and Comercialization of Human Tissue.

Here are a few paragraphs from the letter. Read it in full here. 

I write this letter to you my own name only and not in the name of my institute, of any Government Committees in which I am involved, or of any organisation.  I write because what happens in South Australia on this matter will affect all Australians, particularly those who, like me, meet the requirements of the Bill.

Relevant to this matter is the fact that I am dealing with my own terminal illness (combination of renal failure, advanced ischaemic heart disease and Rheumatoid auto-immune disease) and am dependant on haemodialysis and palliative care.  I have undergone 15 angioplasty procedures and the placement of eight stents to attempt to recover some blood flow after the failure of coronary bypass surgery.  The last such procedure was unsuccessful as the blocked artery could not be accessed.  The Rheumatoid disease causes chronic pleuropericarditis.  I mention these matters only to establish that I am no stranger to suffering and disability, and am well aware of the limitations of palliative care.  It is particularly difficult to control chronic pain because the effectiveness of most forms of pain relief is of limited duration, given the development of therapeutic tolerance.  I have reached the limits of what palliative care can offer.

I cannot speak for all people who suffer from illness and disability, but think I can speak more credibly about suffering, illness and disability than those people who advocate for euthanasia presenting an ideological view of suffering and disability.  Facing illness and disability takes courage and we do not need those euthanasia advocates to tell us that we are so lacking dignity and have such a poor quality of life that our lives are not worth living.

Professionally, I have been involved with issues to do with the care of the terminally ill for many years, having been Australia’s first hospital ethicist, twenty-eight years ago, at St Vincent’s Hospital, Melbourne, where I was also Director of Bioethics for a period of eight years...

As a chronically ill person I know well what it is to feel that one is a burden to others, to both family and community, how isolating illness and disability can be, and how difficult it is to maintain hope in the circumstances of illness, disability and severe pain, especially chronic pain. 

For several years, until I objected, I received from my health insurer a letter that tells me how much it costs the fund to maintain my health care.  I dreaded receiving that letter and the psychological reasoning that would seem to have motivated it.  Each year I was reminded how much of a burden I am to my community.  The fear of being a burden is a major risk to the survival of those who are chronically ill.  If euthanasia were lawful, that sense of burden would be greatly increased for there would be even greater moral pressure to relinquish one’s hold on a burdensome life.  Seriously ill people do not need euthanasia. We need better provision of palliative care services aimed at managing symptoms and maximising function, especially as we approach death.  Rather than help to die, the cause of dignity would be more greatly helped if more was done to help people live more fully with the dying process...

The proposal to make provision for a terminally person who is suffering to request, and a doctor to provide, assistance to die makes it less likely that adequate efforts will be made to make better provision for palliative care services.  Legalised euthanasia would give those responsible for funding and providing palliative care a political “out” in that respect...

In other places, such as the United Kingdom, for instance, which have adopted very liberal policies on other social policies, such as reproductive technology, gay unions and abortion, the Parliaments have strongly opposed euthanasia because euthanasia cannot be made safe for people who are seriously ill and thus vulnerable.  It is worth noting that jurisdictions such as the Netherlands and Belgium that legalised euthanasia, lacked the availability of the kind of palliative care services that developed in the UK. 

~ Andrew Bolt's blog, Herald Sun, Nov 21